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Skeleton undergoes constant remodeling process to maintain healthy bone mass. However, in pathological conditions, bone remodeling is deregulated, resulting in unbalanced bone resorption and formation. Abnormal osteoclast formation and activation play a key role in osteolysis, such as in rheumatoid arthritis and osteoporosis. As potential therapeutic targets or biomarkers, miRNAs have gained rapidly growing research and clinical attention. miRNA-based therapeutics is recently entering a new era for disease treatment. Such progress is emerging in treatment of skeletal diseases. In this review, we discuss miRNA biogenesis, advances in the strategies for miRNA target identification, important miRNAs involved in osteoclastogenesis and disease models, their regulated mechanisms, and translational potential and challenges in bone homeostasis and related diseases.

Objectives: The aim of this study was to reveal the current state of preventive measures and lifestyle habits against heat illness in radiation decontamination workers and to examine whether young radiation decontamination workers take less preventive measures and have worse lifestyle habits than the elder workers. Methods: This was a cross-sectional study. Self-administered questionnaires were sent to 1,505 radiation decontamination workers in Fukushima, Japan. Five hundred fifty-eight men who replied and answered all questions were included in the statistical analysis. The questionnaire included age, duration of decontamination work, previous occupation, lifestyle habit, and preventive measures for heat illness. We classified age of the respondents into five groups

The feasibility of visible and near infrared (VIS/NIR) transmittance spectroscopy for nondestructive discrimination of healthy and diseased onion bulbs was examined. Rottenness occurring in inner scales that were hard to diagnose by the five human senses was targeted. First, VIS/NIR spectra were acquired for six bulb positions. Subsequently, the degree of rot was measured by visual inspection of vertically cut surface based on our proposed criteria and by weighing of sectioned rotted parts. Our evaluation criteria functioned as an alternative mode of the weighing method. The basal plate of onion bulb had remarkable scattering properties. Therefore, spectral features differed not only by the rot levels but also by positioning the bulb against the sensor setup. The partial least squares regression model developed from the longitudinal position, for which the basal plate did not overlap against the system optical axis, showed the best performance and classified rotted bulbs above level 1 with 98.4% accuracy. Absorbance below 736 nm was the informative region for bulb rottenness detection.

Objectives: To reveal the effect of age and other factors on perceived anxiety over radiation exposure among decontamination workers in Fukushima Prefecture, Japan. Methods: A survey questionnaire was sent to 1505 workers, with questions regarding age, presence of a written employment contract, previous residence, radiation passbook ownership, presence of close persons for consultation, knowledge of how to access public assistance, and a four-point scale of radiation-related anxiety (1= "Very much," 2= "Somewhat," 3= "A little bit," and 4= "None" ). The relationships between the degree of anxiety and variables were analyzed using the chi-square test and residual analysis. Results: In all, 512 participants responded to the questionnaire. The mean age of participants was 46.2 years (SD: 13.1, range: 18-77). Of them, 50, 233, 168, and 61 workers chose "Very much," "Somewhat," "A little bit," and "None," respectively, on the anxiety scale. Chi-square test showed that participants aged 61 years and over had higher degrees of anxiety (p

The aims of the present study were to investigate what kind of anxiety radiation decontamination workers have, and to analyze what factors are associated to presence or absence of their anxieties. A self-administered questionnaire was conducted, which included 10 anxiety items. A logistic regression model was then used to determine what factors were related to increased anxiety. Of 531 workers who completed the questionnaire, 477 (91.6%) complained of at least one of the 8 anxiety items. The most common anxiety item was job security (41.8%), and the least common item was working hours (6.0%). The logistic regression analysis revealed that the most common causes of related to presence of anxiety was heat illness and the most common causes of related to absence of anxiety was having someone available for consultation. The current study revealed the kinds of anxiety, and the factors associated with presence or absence of each anxiety among radiation decontamination workers. These results provide important implications for the improvement of educational content and occupational health management for radiation decontamination workers in the future.

Along with the aging of the Japanese agricultural population in recent years, the nation’s food self-sufficiency rate has declined. The vitality of agriculture has also declined. This study specifically examines the food supply chain to integrate farm production, manufacturing, and sales. For the food supply chain, it is necessary to ascertain the harvest time of field crops for establishing proper sales strategies. A method to predict harvest time from field crop images using convolutional neural networks (CNN) is proposed. Then the effectiveness of the proposed method is verified using computer experiments. Results show that the discrimination rate is high in the early stage of the growth, even if misclassification occurs. Labels close to the correct answer are predicted. However, the discrimination rate is not so high and the deviation from the correct answer becomes greater in later stages of growth.

OBJECTIVES: The aim of this study was to reveal factors related to heat illness in radiation decontamination workers and determine effective preventive measures. METHODS: A self-administered questionnaire was sent to 1,505 radiation decontamination workers. The questionnaire included age, sex, duration of decontamination work, previous occupation, education provided by employers regarding heat illness, preventive action against heat illness, and subjective symptoms of heat illness during work. We included 528 men, who replied and answered all questions, in the statistical analysis. Subjective symptoms of heat illness were categorized as "no symptoms," "Grade I" and "Grade II" according to severity. A multiple linear regression model was used to determine the factors associated with the severity of heat illness. RESULTS: The mean age of the subjects was 47.6 years old (standard deviation: 13.4). Of the 528 workers, 316 (59.8%) experienced heat illness symptoms (213 at Grade I and 103 at Grade II). The results of the stepwise selection revealed that age, outdoor manual labor, adequate sleep, use of a cool vest, and salt intake were selected as preventive factors, whereas living in a company dormitory or temporary housing, wearing light clothing, and consuming breakfast were selected as risk factors for heat illness. CONCLUSIONS: Both working conditions and living environment are associated with heat illness in radiation decontamination workers. Type of housing and sleep are also strongly related to heat illness during work. Employers should consider not only the working conditions of the employee but also the employee's daily living conditions, in order to prevent heat illness. Language: en

A 65-year-old man was admitted into our hospital because of the detailed examination for abnormal Q waves in inferior leads on an electrocardiogram. Coronary angiography and 320-row area detector computed tomography (ADCT) revealed “dual left anterior descending artery (LAD)”, which was a rare anomaly of the LAD and chronic total occlusion (CTO) at segment 2 of the right coronary artery (RCA). The course of the anomalous LAD arising from the proximal portion of the RCA was specifically identified between aortic root and right ventricular outflow tract (RVOT) by 320-row ADCT. The anomalous LAD had potential risk of myocardial ischemia because of the compression from aortic root and RVOT during exercise. We performed technetium myocardial perfusion scintigram to evaluate exercise-induced ischemia in the territory of the anomalous LAD and to decide therapeutic strategies including coronary artery bypass grafting surgery to the vessel. The scintigram revealed no exercise-induced ischemia in anteroseptal wall and a constant perfusion defect in posteroinferior wall of the left ventricle. Thus, we decided to treat the patient with pharmacological treatment in the outpatient setting. This report suggests that it is important to recognize the variants of coronary arteries for optimal treatment.

This paper presents a new form of Particle Swarm Optimization (PSO) based on the concept of tabu search (TS). In PSO, when a particle finds a local optimal solution, all of the particles gather around that one, and cannot escape from it. On the other hand, TS can escape from the local optimal solution by moving away from the best present solution. The proposed Tabu List PSO (TL-PSO) is a method for combining the strong points of PSO and TS. This method stores the history of pbest in a tabu list. When a particle has a reduced searching ability, it selects a pbest of the past from the historical values, which is used for the update. This makes each particle active, and the searching ability of the swarm makes progress. The proposed method was validated by numerical simulations with several functions that are well known as optimization benchmark problems for comparison to the conventional PSO method. © 2010 Wiley Periodicals, Inc. Electr Eng Jpn, 172(4): 31–37, 2010; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.20966

We report two neonatal patients with high-flow intracranial or cervical arteriovenous (AV) shunts who presented with congestive heart failure and were successfully managed with endovascular treatment. One with vein of Galen malformation with body weight of only 2.0 kg is, to our knowledge, the smallest neonate successfully treated with endovascular treatment. The other neonate is, to our knowledge, the first vertebro-vertebral fistula patient presenting with heart failure and treated successfully with endovascular treatment. Even in neonates, endovascular treatment is the procedure of choice for high-flow AV shunts presenting with progressive congestive heart failure resistant to medical management. We discuss limitations and technical considerations of endovascular treatments in small neonates with high-flow AV shunts and congestive heart failure.

Objective We sought to evaluate from a behavioral and histological viewpoint the effect of local administration of glial cell line-derived neurotrophic factor (GDNF) on neonatal preganglionic Erb's palsy in rats. Methods The Erb's palsy model was produced by transecting the anterior and posterior roots of the left C5-C7 nerves of 7-day-old rats. The rats were divided into GDNF-treated (n = 10) and vehicle-treated groups (n = 11). After we transected the roots, contact in the proximal and distal stumps of the transected nerves was maintained, and the transected point and the entire intraspinal portion of the transected roots were enclosed by Gelfoam soaked with 10 micro g GDNF or saline. The behavioral evaluation consisted of a foot-fault test and a forepaw muscle strength test, all of which were performed from the third to the seventh weeks after the operation. Seven weeks after the operation, all rats were killed, the number of anterior horn cells was counted at C5-C7, and the differences on each side were compared. Results In the vehicle-treated group, the foot-fault test indicated an abnormality in forelimb function on the root transection side. In the GDNF-treated group, however, significant improvement in forelimb function was observed on the basis of the foot-fault test results obtained in the third to sixth weeks after the operation. In the histological evaluation, the number of anterior horn cells from the side in which the operation took place in the vehicle-treated group was significantly less than that taken from the contralateral side at each segment. In the GDNF-treated group, however, there was no difference in any of the segments, regardless of the side from which they were taken. Conclusion Local administration of GDNF in a neonatal preganglionic Erb's palsy model resulted in significant improvement in deficits on the basis of behavioral and histological evaluations.

✓ SThe authors devised a paramedian transmuscular approach to the C2–3 facet joint that enabled total removal of C-3 dumbbell-type neurofibroma; dissection of the paravertebral muscles from the spinous process was not required and the facet joint was preserved. Only splitting or retraction of the paravertebral muscles was necessary. The anatomical features and procedures involved in muscle splitting are described.

In a previous study, we demonstrated that the expression levels in tumor cells of emmprin (CD147) correlated with the grade of astrocytic tumors. Also, we found that emmprin was expressed in vascular endothelial cells of the non-neoplastic brain and hypothesized that emmprin expression could be associated with normal blood-brain-barrier (BBB) function of vascular endothelial cells. In this study, this possibility was examined in non-neoplastic brain, glioma and metastatic carcinoma tissues by comparing emmprin immunohistochemistry with gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) enhancement of magnetic resonance imaging (MRI), which is a clinical indicator of the BBB function. This study included 10 cases of non-neoplastic brain tissues, 7 of metastatic carcinoma, 7 of diffuse astrocytoma, 4 of anaplastic astrocytoma and 13 of glioblastoma multiforme. In all the cases, MRI with administration of Gd-DTPA was performed. The lesions were resected using the microdissection method with the help of ultrasonography and a neuronavigator. The tissues from Gd-DTPA-enhanced or non-enhanced areas were processed into frozen sections and subjected to immunohistochemistry with anti-emmprin antibody. The expression of emmprin in brain vascular endothelial cells inversely correlated with Gd-DTPA-enhancement of MRI: emmprin was positive in tissues not enhanced by Gd-DTPA and was negative in DTPA-enhanced tissues. Since BBB function presumably remains unimpaired in regions in which MR images are not Gd-DTPA-enhanced, emmprin expression appears to be associated with unimpaired BBB function. This is the first report to demonstrate a possible correlation between emmprin expression and BBB function in humans.

Cervical compressive myelopathy patients sometimes show localized girdle sensation in the mid trunk (so-called false localizing sign). This symptom often confuses physicians, but the clinical features and mechanism of this symptom are still unclear. We investigated the clinical features and possible mechanism. In each of five cases of cervical compressive myelopathy disease with and without mid-truncal girdle sensation, the clinical features, degree and shape of cord compression were analysed. The girdle sensation was expressed as a vague or burning sensation, and was localized with a width of 3 or 4 dermatomes from the T3 to T11 level. There was no correlation between the appearance of the girdle sensation and etiology and level of cervical cord compression. Pyramidal tract signs and disturbance of superficial sensation were observed in all cases. Furthermore, on axial MRI, the midline ventral surface of the cervical cord was remarkably compressed in cases with girdle sensation, as if the compressive lesion entered the anterior medial fissure of the cervical cord. From these findings, this false localizing sign may be caused by severe compression of midline ventral structure of the cervical cord. Ischemia of the thoracic watershed zone of the anterior spinal artery from the compression of the anterior spinal artery at the cervical level might also be considered to be a possible cause.

A 59-year-old male presented with a large cholesterol granuloma arising from the frontal sinus manifesting as a large, fluctuated, soft mass in his brow, compressing left eye. Skull radiography showed dilation of the frontal sinus. Computed tomography and magnetic resonance imaging revealed a cystic mass extending into the left orbit and anterior cranial fossa. Gross inspection at the frontal craniotomy showed mucinous, dark green fluid intermingled with shining material. The histological diagnosis was cholesterol granuloma with epithelial lining. Large cholesterol granuloma with facial deformity is always associated with bone and cosmetic problems. Wide opening of the frontal sinus followed by cyst wall removal and plastic repair of the skull is necessary.

AIM: To investigate the correlation between angiographic cerebral circulation time (CCT) and cerebral blood flow (CBF) evaluated by single photon emission computed tomography (SPECT) before and after endovascular treatment for symptomatic vasospasm. MATERIALS AND METHODS: Seven patients with unilateral vasospasm as demonstrated by catheter angiography who underwent pre- and post-treatment SPECT were selected. All patients had angiographic vasospasm of unilateral middle cerebral artery (MCA). Eight vessels in seven patients underwent intra-arterial papaverine infusion and three vessels underwent percutaneous transluminal angioplasty. Angiographic CCT was defined as the interval from the first image in which contrast medium was visible at the origin of MCA to its disappearance from the cortical arteries in the MCA territory. In SPECT studies, the ischaemic degree in MCA territory was analysed by side to side comparison with calculating the asymmetry index (AI). RESULTS: The pre-treatment mean CCT was 4.1 ± 0.8 s. The mean CCT immediately after treatment was 2.7 ± 0.5 s. In the control subjects (n = 15) with unruptured aneurysm, mean CCT was 3.5 ± 0.2 s. The pre-treatment mean CCT was significantly prolonged compared with that in the control subjects (P = 0.02). The post-treatment mean CCT was significantly shortened compared with that in the control subjects (P = 0.001). The pre-treatment mean AI was 71.2 ± 7.4%, and that immediately after treatment was 90.5 ± 3.6%. AI increased in all territories treated with endovascular treatment; the mean change was 19.3%. Angiographic CCT was closely correlated with AI in both pre- (r = − 0.95) and post-treatment (r = − 0.79). CONCLUSION: Measurement of CCT is useful in evaluating cerebral haemodynamics of endovascular treatments in patients with cerebral vasospasm.Iseda, T., (2000). Clinical Radiology55, 679–683.

OBJECTIVE This study investigated the cerebral blood flow (CBF) thresholds of ischemic cortices that were salvageable with intravenous tissue plasminogen activator (t-PA) infusion therapy. METHODS We retrospectively reviewed data for 20 patients who were treated with intravenous low-dose (7.2 mg) native t-PA infusion therapy for distal embolic occlusions of middle cerebral artery divisions or branches, without early computed tomographic ischemic changes. All patients underwent pretreatment single-photon emission computed tomographic CBF measurements using (99m)Tc-N,N'-(1,2-ethylenediyl)bis-L-cysteine diethylester. Intravenous t-PA infusion was initiated within 6 hours (average, 3 h) after symptom onset for 14 patients and 6 to 14 hours (average, 8.8 h) after the last time the patient was noted to be in normal condition for the other 6 patients. Pretreatment single-photon emission computed tomographic and 3-month post-treatment computed tomographic scans were compared using computerized coregistration. Ischemic cortices in single-photon emission computed tomographic scans were divided into areas of reversible and irreversible ischemia. The degree of hypoperfusion was analyzed with an asymmetry index (AI). The AI was calculated as C(a)/C(b) x 100%, where C(a) represents the mean reconstructed counts for the ipsilateral ischemic area and C(b) represents the mean reconstructed counts for the corresponding contralateral area. RESULTS Partial recanalization, with clinical improvement, at 60 minutes was confirmed by angiography for 14 of the 20 patients (70%). Seventeen of the 20 patients (85%) exhibited major neurological improvements (defined as decreases in National Institutes of Health Stroke Scale scores of > or =4 points) at 24 hours, suggesting that recanalization occurred within 24 hours for almost all patients. AIs for the 25 irreversible lesions ranged from 15.0 to 53.4% (37.3 +/- 11.6%), whereas AIs for the 38 reversible lesions ranged from 45.0 to 83.1% (69.3 +/- 8.6%). There was a significant difference in the AIs for these two groups (P < 0.0001). The ischemia in tissue with AIs of more than 53.4% was reversible. In contrast, ischemic tissue with AIs of less than 45.0% could not escape cerebral infarction with our treatment. The ischemia in tissue with AIs between 45.0 and 53.4% was reversible in some patients and irreversible in others. CONCLUSION To save ischemic tissue with our intravenous t-PA infusion therapy, residual CBF should be at least 45% of the contralateral presumed normal CBF value. CBF thresholds for ischemia that would be surely salvageable with our intravenous t-PA infusion therapy might be approximately 50 to 55% of the contralateral presumed normal CBF values.

We prospectively evaluated the safety and efficacy of an intravenous infusion of low-dose native tissue plasminogen activator for distal embolisms in the middle cerebral artery divisions or branches.Twenty patients were selected according to the following computed tomographic and angiographic criteria and treated with intravenous infusion of 7.2 mg of tisokinase: 1) no early ischemic changes on the initial computed tomographic scan, and 2) embolic occlusion of the middle cerebral artery divisions or branches without the involvement of the lenticulostriate arteries. For comparison, the records of 12 patients from previous years who met the above inclusion criteria but underwent no thrombolytic therapy were reviewed retrospectively. The degree of neurological recovery was assessed using the National Institutes of Health Stroke Scale at 24 hours after admission. Major neurological improvement was defined as a decrease in the stroke score by 4 points or more.There was no significant difference in stroke scores at the time of admission between the treatment group (mean +/- standard deviation, 12.8 +/- 2.8) and the untreated group (14.0 +/- 2.4). In the treatment group, major neurological improvement was seen in 17 (85%) of 20 patients, whereas in the untreated group only 5 (41.7%) of 12 patients showed major neurological improvement (P0.05). The mean score at 24 hours in the treatment group (3.6 +/- 3.5) was significantly lower than that in the untreated group (9.4 +/- 7.3) (P0.05). There was no hemorrhagic complication with neurological exacerbation in the treatment group.Even with delayed initiation (3 h after symptom onset), intravenous infusion of low-dose tisokinase may be safe and effective for small distal emboli in the middle cerebral artery divisions or branches, when early ischemic changes on computed tomographic scans and involvement of the lenticulostriate arteries are absent.

BACKGROUND We describe techniques combining wrapping and clipping using a collagen-impregnated Dacron knitted fabric (Hemashield) for accidental arterial perforations and broad-based aneurysms. The results of these techniques in seven patients are presented. METHODS Clip-reinforced wrapping was performed to obtain hemostasis in two patients with arterial perforations and in a patient with a ruptured broad-based aneurysm in the internal carotid artery. Clipping of the broad neck of the aneurysm and wrapping with Hemashield (wrap-clipping) was performed in four patients with unruptured aneurysms (one internal carotid artery, two middle cerebral artery, one basilar artery). RESULTS In the three patients treated with clip-reinforced wrapping, complete hemostasis was obtained just after clip application. In the patient with a ruptured broad-based aneurysm, postoperative angiography demonstrated that the dome of the aneurysm was well compressed. In the four patients treated with wrap-clipping, postoperative angiography revealed successful clipping of the broad neck of the aneurysm. CONCLUSION In this early experience, there were no problems in the use of Hemashield for clip-reinforced wrapping or wrap-clipping.

九州・沖縄地区の平成9年度の脳梗塞急性期再灌流療法の実態調査のために,脳神経外科,神経内科のある195施設にアンケート調査を行い,117施設(60.0%)より回答を得た.そのうち脳梗塞急性期医療を行っている109施設について検討した。CTで異常がない急性期脳梗塞に対して血管閉塞部位診断を行う施設は全体の67.0%で,大部分がdigital subtraction angiography (DSA)あるいはmagnetic resonance angiography (MRA)を行っており,ultrasonography (US)やcomputed tomographic angiography (CTA)を行う施設は全体の2～3割であった.何らかの再灌流療法を試みる施設は全体の58.7%で,神経内科の53.3%,脳神経外科の28.1%の施設が再灌流療法は考慮しないという結果であった.再灌流療法として最も多くの施設で行われていたのはウロキナーゼの点滴静注で(51.6%),次いでマイクロカテーテルを用いた局所線溶療法(50.0%),血管造影用カテーテルからの血栓溶解薬の動注(46.9%)の順であった.

This study was conducted to explore whether anthropometric indices of obesity are associated with atherogenic risk factors in young adult working women in Japan. The subjects were 492 women in an occupational setting. Predictor variables were body mass index (BMI), the sum of triceps and subscapular skinfold thickness (SFT), and the waist to hip ratio (WHR). Outcome variables were serum total cholesterol, triglyceride and blood pressures. The average age of the subjects was 26.3 (SD 3.9) years. The upper quartiles of BMI and SFT were significantly associated with all atherogenic risk factors, while the upper quartiles of WHR were not. Multiple comparisons revealed the 4th quartiles of BMI (> 22.25) and SFT (> 39 mm) to have significantly higher values for all atherogenic risk factors. We found that BMI and skinfold thickness were more relevant to the prediction of atherogenic risk factors than WHR in young adult Japanese women.

The aims of the present study were to identify correlates of alanine aminotransferase (ALT or GPT) and aspartate aminotransferase (AST or GOT) activities among a healthy working population aged 18-39, and to discuss liver transferase abnormalities. Subjects included 1,009 employees of a company in Fukushima, Japan. Pregnant women, employees exposed to organic solvents, and employees with a history of liver diseases were excluded. Serum ALT and AST levels were measured by an enzymatic method. Other information including BMI, job type and lifestyles was recorded. Mean ALT and AST levels were significantly higher for males than females (P0.001). Multiple linear regression analysis revealed that sex and BMI explained 45% and 31% of the variability in ALT and AST, respectively. The prevalence of abnormal ALT levels (40 IU) was 16.3% for males and 0.4% for females. Sex, BMI, and shift work were independently associated with abnormal ALT levels by logistic regression analysis. It is concluded that ALT and AST levels are well-correlated with sex and BMI, and that abnormal liver transferase activity is prevalent in male employees but rare in females, suggesting that liver function tests should be introduced for male employees under 40 years of age.

A 47-year-old female presented with a transitional type meningioma entirely confined to the fourth ventricle. The tumor was totally resected. A 67-year-old female had undergone resection of an intraventricular transitional type meningioma of the fourth ventricle 9 years previously. She presented with a new meningioma of an obviously different origin at the posterior rim of the foramen magnum. The new meningioma was totally resected and the histological diagnosis was atypical meningioma. The magnetic resonance (MR) imaging characteristics of these two intraventricular meningiomas of the fourth ventricle were isointense and slightly hypointense to gray matter on the T1-weighted images, and hyperintense to gray matter on the T2-weighted images, with intense and homogeneous enhancement with gadolinium. Angiography showed the two intraventricular meningiomas fed by branches of the posterior inferior cerebellar arteries or superior cerebellar arteries. The second meningioma with dural attachment was fed by the right occipital artery. Intraventricular meningiomas of the fourth ventricle are not supplied by meningeal branches from vertebral and external cerebral arteries. MR imaging is the most useful tool in preoperative diagnosis, but cerebral angiography should also be performed to confirm the feeding vessels and the correct diagnosis.

This paper presents K-NET, a general-purpose simulator for factory automation (FA) systems, that stimulates a system model based on Petri net. First, net elements for modeling, the model editing function, and the simulation function are explained; and then a planning system is described for automatic storage/retrieval systems that utilize the K-NET simulation function, which automatically generates a simulation model, animates the system behavior, and evaluates system performance. Finally, a distributed simulator for large FA systems and an example application of the tool are described.

Recently, electric power systems have faced increasing uncertainties in demand, energy price and environmental constraints in the future. In such a situation, a plan for expansion of the system capacity must be made robust against the aforementioned uncertainties. Large-scale power plants require a long time for construction so that the decision of construction must be made under much uncertainty in the future. On the other hand, small-scale plants require less time for construction, i.e., the decision can be made under less uncertainty in spite of their relatively higher costs. This paper is concerned with an optimal combination of the large-scale and the small-scale plants having the aforementioned characteristics under uncertainty of future demand. First, the demand growth in the future is described by scenarios of demand growth branching like a tree. Then the optimization problem of the system expansion is formulated into a stochastic linear-programming problem. An optimal solution of the problem is obtained by using the scenario-aggregation algorithm proposed by Rockafellar and Wets. The simulation results, yielded by using a parallel computation on transputers, show that there is a possibility of constructing small-scale power plants to cope with the uncertainty even if they are more expensive than the large-scale plants.

Thrombolysis has become accepted as an effective treatment for acute ischemic stroke. However, two major problems remain: failure of recanalization and hemorrhagic complications. The combined use of mechanical recanalization techniques with thrombolytic agents occasionally may be required to improve recanalization rates and to reduce hemorrhagic complications. Percutaneous transluminal angioplasty (PTA), clot extraction utilizing retrieval devices, and clot fragmentation using energy of ultrasonic or laser vibrations and suction-creating saline jets are possible effective mechanical recanalization strategies, but mainly as a rescue therapy for patients with failed thrombolysis. However, for large artery occlusions, thrombolysis alone often results in failure of recanalization. In such cases, to minimize the total dose of thrombolytic agents and to prevent hemorrhagic complications, mechanical recanalization may be alternatively selected as the first choice of treatment. The safety and effectiveness of PTA for acute middle cerebral artery trunk occlusion has been reported using additional thrombolysis with low doses of thrombolytic agents for distal embolism by crushed fragments. Reduction of total doses of thrombolytic agents may decrease serious hemorrhagic complications, resulting in better clinical outcome.

An unusual case of glioblastoma with adenoid structures arising in a 30-year-old Japanese woman with neurofibromatosis type-1 (NF1) is reported. The patient was admitted to University of Miyazaki Hospital, complaining of headache, nausea and vomiting. From the neuroradiological findings the patient was diagnosed as having glioblastoma, and the tumor was surgically resected. Histologically, the tumor consisted mainly of dark basophilic cells showing prominent tubular or glandular structures surrounded by large eosinophilic cells, in addition to the typical glioblastoma features in the periphery of the tumor. Both cells showed strong stainability with glial fibrillary acidic protein (GFAP) and S-100 protein immunohistochemically, so that the tumor was classified as adenoid glioblastoma. Several cases of glioblastoma have been reported to reveal the adenoid or epithelioid differentiation. The patients with NF1 are prone to develop malignant tumors including glioblastoma, but no cases representing adenoid glioblastoma associated with NF1 have been reported. This report is considered to be the first case of adenoid glioblastoma arising in a patient with NF1. The recognition of the existence of epithelial features of glioblastoma would be important in differential diagnosis of epithelioid tumors of the brain including metastatic carcinomas.

AIM To investigate how often early computed tomography (CT) signs are associated with blood–brain barrier (BBB) disruption and result in haemorrhagic transformations. MATERIALS AND METHODS Serial CT findings were prospectively evaluated in 61 patients with acute middle cerebral artery (MCA) occlusion who underwent initial CT examination within 3 h of stroke onset and who were treated with intra-arterial reperfusion therapy within 6 h of stroke onset. Obscuration of the margin of the lentiform nucleus and loss of the insular ribbon were evaluated as early CT signs in the deep MCA territories. Cortical effacement was also evaluated. BBB disruption was defined as contrast medium staining in post-therapeutic CT just after reperfusion therapy. The relationship between pre-therapeutic early CT signs and post-therapeutic contrast staining or haemorrhagic transformations was investigated. RESULTS The frequency of early CT signs in the deep MCA territories was significantly higher than that of cortical effacement (68.9 versus 27.9%). There were significant correlations between pre-therapeutic early CT signs and post-therapeutic contrast staining in both the deep and superficial MCA territories. Compared with early CT signs in the deep MCA territories, cortical effacement had a significantly higher incidence of post-therapeutic contrast staining (54.8 versus 82.4%). Although not statistically significant, cortical effacement tended to develop into haemorrhagic transformations. There was no correlation between early CT signs in the deep MCA territories and haemorrhagic transformations. CONCLUSION Cortical effacement may be an advanced CT sign with BBB disruption and potential risk for haemorrhagic transformations. The presence of early CT signs in the deep MCA territories may not be a contraindication of reperfusion therapy.

Background and Purpose— The purpose of this study was to evaluate the correlation between appearance of angiographic early venous filling during intra-arterial reperfusion therapy and posttherapeutic hemorrhagic complications. Methods— For the past 7 years, 104 patients prospectively underwent superselective local angiography via a microcatheter before and during intra-arterial reperfusion therapy for acute middle cerebral artery occlusion to evaluate the presence or absence of early venous filling. In principle, reperfusion therapy was discontinued just after appearance of early venous filling for fear of hemorrhage. There were 2 types of early venous filling: early filling of the thalamostriate vein from the lenticulostriate arteries and that of the cortical vein from the cortical arteries. Results— Among these 104 patients, 31 (29.8%) had early venous filling: 19 had early filling of the thalamostriate vein, and the other 12 had early filling of the cortical vein. Eight of the 19 patients (42.1%) and 2 of the 12 patients (16.7%) had massive hematoma with neurological worsening, whereas only 1 of the 73 patients (1.4%) without early venous filling had massive hematoma. There was a significant correlation between early venous filling and massive hematoma in both the deep ( P P =0.0019) middle cerebral artery territories. The sensitivity and specificity of the presence of early venous filling as an indicator of parenchymal hematoma were 71% and 83%, respectively. None of the 31 ischemic areas with early venous filling could escape cerebral infarction. Conclusions— Appearance of early venous filling may indicate irreversible brain damage and may be a predictive sign for parenchymal hematoma.

A series of basic experiments for an accelerator driven subcritical reactor (ADSR) has been performed at the Kyoto University Critical Assembly (KUCA) by combining a critical assembly with a Cockcroft-Walton type accelerator in view of a future plan to establish a new neutron source for research. Fourteen MeV neutrons were injected into a subcritical system through the polyethylene reflector. By varying subcriticality, the neutron multiplication and the prompt neutron decay constant as well as the subcriticality were measured mainly by an optical fiber detector system. Calculations were executed by a continuous energy Monte Carlo code MVP on the basis of JENDL-3.2 to examine the accuracy of neutronics design for the ADSR at the present stage. A large discrepancy was observed between the measured subcriticality and the calculated one mainly because of an inadequate evaluation of 235 U nuclear data compiled in JENDL-3.2, which leads to a large difference among the measured and calculated nuclear parameters of the ADSR. Through the present study, it was strongly recognized that the present tools for the neutronics design calculation of ADSR are not accurate enough especially to predict the neutron multiplication in the ADSR. Although the accuracy of keff calculation is becoming better and better in the current neutronics design tools for nuclear reactors, one should be careful that the neutron multiplication in the ADSR does not depend on keff itself, but approximately on 1/(1-keff).

A neonatal upper brachial plexus injury, referred to as Erb's palsy, is a serious obstetric problem. Some surgical methods are used to treat this injury, but they are inadequate. To seek new treatments for Erb's palsy, we used a model for cervical preganglionic root transection in neonate rats and evaluated the behavioral and histological compatibility of this model with Erb's palsy. Two groups were used in this study. In the group, receiving the Erb operation, the left anterior and posterior roots of spinal vertebra C5-C7 were transected at the preganglionic level, and the results were compared with those of a group that received a sham operation. In the group, receiving the Erb operation, walking difficulties and behavioral abnormalities were observed. These observations were noted on the side where the transection took place, and the problems were attributed to proximal muscle weakness in the forelimb. Additionally, the forepaw grip was not impaired. Furthermore, in this group, the number of anterior horn cells in the cervical cord on the transected side was significantly lower than that on the contralateral side (P < 0.001). The results of this study indicate that the model fulfills the criteria for the clinical symptoms of Erb's palsy and that it may also serve as a new method for enabling treatment of the condition.

A rare case of pituitary metastasis of thyroid follicular adenocarcinoma occurred in a 62-year-old female manifesting as left retro-orbital pain and diplopia. Computed tomography and magnetic resonance imaging revealed a tumor in the pituitary fossa extending to the left cavernous sinus, sphenoid sinus, and prepontine cistern, destroying the upper portion of the clivus. An asymptomatic thyroid mass, probably malignant, was also found. She also had an incidental small meningioma in the posterior fossa. The pituitary tumor was partially removed, and the thyroid and posterior fossa tumors were totally removed in two operations. Both pituitary and thyroid tumors were verified to be follicular adenocarcinoma. Postoperatively, she developed panhypopituitarism for which cortisol and thyroxine replacement therapy was necessary. Three years after first therapy, she was alive but her symptoms did not improve.

To the Editor: We have read with great interest the article by Wildermuth et al1 on the role of CT angiography (CTA) in patient selection for thrombolytic therapy. The authors report that selection of patients with little potential for benefit from thrombolytic therapy is feasible with the use of CTA. The CTA findings, such as no vascular occlusion (ie, identification of patients with autolyzed thrombi), occlusion of internal carotid artery bifurcation, and poor leptomeningeal collaterals, indicate little potential for benefit from thrombolytic therapy. I am sure that these 3 CTA findings are useful in patient exclusion from thrombolytic therapy. However, there are 3 major problems with the use of CTA in patient selection for thrombolytic therapy. First, CTA has diagnostic limitations of precise information about lenticulostriate artery (LSA) involvement. When …

As a follow-up to a case previously reported, a rare case of malignant transformation of cellular blue nevus (CBN) in the central nervous system preoperatively diagnosed by magnetic resonance imaging (MRI) is reported. On MRI, the malignant portion of the nevus was slightly hyperintense on both T1- and T2-weighted images. In contrast, the benign portion with a great deal of melanin was hyperintense on T1-weighted image and hypointense on T2-weighted image. MRI was useful and indispensable for detecting the malignant transformation of CBN.

Two cases of rare intracranial and orbital metastasis of hepatocellular carcinoma are presented. A 61-year-old woman was found to have a metastatic tumor in the right temporo-occipital lobe 1 year after undergoing treatment for a primary hepatoma. An osteolytic tumor was removed from the left orbit of a 58-year-old man and the primary tumor, a hepatoma, was discovered postoperatively. The intracranial and orbital tumors were verified to be hepatocellular carcinoma. Both patients died within 1 year of surgery. The relevant literature is briefly reviewed.

This paper describes the procedure for determining surface crack shape using the Line Spring Analysis in the electric potential method. Line Spring Analysis can be used to solve three-dimensional electric potential problems by use of personal computers, over a short computational time. The hardware and software systems for the determination of surface crack shape are developed using a personal computer, based on Line Spring Analysis. A demonstration was made for a semi-elliptical surface crack in a rectangular A 533 B steel plate, and the determined crack shape coincided with the real one.

The effect of repetition of brief ischemia, which causes no morphological brain damage when given as a single insult, was studied. Two-minute forebrain ischmia was induced in gerbils singly and 3 or 5b times at 60-min intervals. Although 2-min ischemia induced no neuronal damage, 3 or 5 repeated ischemic insults caused neuronal damage in the selectively vulnerable regions, the severity being dependent on the number of episodes.

The effect of a serotonin S2 antagonist, naftidrofuryl, on ischemic neuronal damage was examined in the gerbil. Naftidrofuryl was injected i.p. 5 min prior to a single 5-min forebrain ischemia or immediately after each of three 2-min forebrain ischemic insults at 60-min intervals. In both groups the number of intact hippocampal CA1 neurons were significantly higher than in the saline-treated group. These results indicate that serotonin S2 antagonists have a protective effect against ischemic neuronal damage.

The discrepancy between three methods for cerebral perfusion imagings in the case of a man with meningioma is presented. Imaging with N-isopropyl-P-[I-123] iodoamphetamine (IMP) showed no activity in the tumor. Imaging with Tc-99m hexamethylpropyleneamine oxime (HM-PAO) and the local cerebral blood flow (LCBF) image with Xe-133 inhalation showed high tumor activity. IMP is a more accurate method for imaging the brain tissue blood flow.

The materials used were 20 cases of leukemoid reaction with myeloblasts in their circulating blood and 39 cases of myeloid leukemia.

A 58-year-old female had a 1-year history of headache, ataxia, and taste disturbance and then developed speech disturbance. She was found to have a meningioma of the fourth ventricle, a very rare site for this type of tumor. It did not adhere to the cerebellar tentorium or dura mater and was totally removed without difficulty. Magnetic resonance imaging, but not computed tomography or angiography, provided adequate information for correct diagnosis. The literature concerning fourth ventricle meningiomas is reviewed and the diagnostic advantages and limitations of computed tomography, angiography, and magnetic resonance imaging are discussed.